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The New Patient Phenomenon
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Written by Dr. Eric Kaplan, D.C., F.I.A.M.A.   
Friday, 30 May 2003 00:00

Scheduling the New Patient
When scheduling a new patient, it is very important that you are conscientious to do the following three things in order to insure the new patient will not have to wait and that their first visit will be a successful one.
1. Select an appropriate time, allowing the doctor enough time to consult with, examine and X-ray the new patient.
2. Make sure the appointment time you communicate to the new patient is fifteen minutes earlier than the time actually scheduled in your appointment book.
3. Make sure you have properly recorded the new patient appointment in the book.

Allow Enough Time for the Doctor
Iorder to provide the doctor with adequate time to see a new patient, typically you will need to block out forty-five minutes to an hour.  However, this may vary depending on the individual doctor and whether or not your clinic has an examination doctor or a certified X-ray technician on staff.
The best way to insure that you have forty-five minutes to one-hour blocks of time available to see potential new patients is to “cluster book.”  The cluster booking technique is briefly described below for the purpose of understanding how to schedule a new patient.

Cluster Booking
Cluster booking is the primary method of patient control and provides increased efficiency in time management. It allows the doctor to keep his mind in a treatment, examination, or paperwork mode for a segment of time. It is extremely exhausting, both mentally and physically, for the doctor to do paperwork, treat a patient, examine a patient, sit down, treat a patient, etc. 
The cluster booking technique involves establishing four treatment modes, or clusters, per day in which you schedule patients for adjustments and therapy.  Each treatment mode has a start time, from which you begin scheduling patients continuously towards the next cluster,  lunch or closing time.  There are two morning clusters and two afternoon clusters.
By scheduling treatment in clusters, there will naturally be holes or blocks of time between the treatment modes.  These holes are used to schedule new patients and other special services, such as re-exams, report of findings, etc.  This way the doctor is able to devote the necessary time to the new patient, without making other patients wait.
Note:  If the patient is acute and needs emergency relief, work them into your schedule, even if you do not have enough time available for a new patient.  You can do a brief examination and give the patient relief care, scheduling the complete chiropractic, orthopedic, and neurological exam for the following day.  Remember, new patients are the lifeblood of your practice; you must be available when they need you.

The Appointment Time Communicated to the Patient Should Be 15 Minutes Earlier than the Actual Appointment Time
By having the patient come fifteen minutes early, you allow time for them to fill out the necessary paperwork, without throwing the doctor off schedule.  If the new patient arrives at the actual scheduled time, the doctor has to wait while the patient fills out the necessary forms and, consequently, is fifteen minutes behind schedule when other patients begin to arrive.

Make Sure You Properly Record Appointment in the Book
When scheduling a new patient appointment in your book, make sure you write NP in the services column to the left of their name.  (Personally, I like to color code my appointment book).  You must also be conscientious to write their phone number under their name so that you can call to remind them of their appointment, or call them to reschedule if they miss the appointment
Be sure to block out the necessary time below their name, so someone else cannot be scheduled in that time and cut the new patient appointment time in half.
Finally, make sure that you highlight the new patient appointment in yellow, so that it stands out in your appointment book.  This will help you to remember to do the necessary preparation prior to the new patient appointment.

New Patient Flow
Now that the patient has scheduled his first appointment, proper procedures must be followed.  There are three important procedures that must be performed in order to deliver the best quality care to each patient.  These procedures are comprised of three steps.

  1. Consultation and preliminary examination;
  2. Orthopedic, neurological, chiropractic and physical examinations, and X-rays, if indicated;
  3. Report-of-Findings and treatment.

The consultation and preliminary examination are used to determine if a new patient is a chiropractic candidate.  The complete orthopedic, neurological, chiropractic and physical examinations are administered to provide the doctor with the necessary findings for diagnosis, prognosis and a recommended plan of treatment.  X-rays usually play an important role in the diagnosis of spinal problems, and are generally necessary to rule out conditions that would require the patient to be referred to another specialist.  However, some new patients may be transferring care from another physician who might be able to provide you with recent X-rays.  Finally, the Report-of-Findings allows the doctor to explain the documented findings and treatment plan to the new patient.
Once again, these procedures can be performed over one or two visits, depending upon individual circumstances; however, all three steps must be covered thoroughly.  It is also to be noted, a patient may require emergency (relief) care on the first visit.  In the new world of compliance, we must document what we do.  It begins with the first visit of any new patient. TAC

Dr. Eric Kaplan is the CEO of MBA, Inc., one of the nation's largest multi-specialty consulting companies.  Dr. Kaplan ran and operated five  of his own clinics, seeing over 1000 patient visits per week.  He is the best-selling author of Dr. Kaplan’s Lifestyles of the Fit and Famous, endorsed by Donald Trump, Norman Vincent Peale and Mark Victor Hansen.  He was a recent commencement speaker at New York Chiropractic College and regularly speaks throughout the country.  For more information about Dr. Kaplan or MBA, call 561-626-3004.

Homeopathic Miasms: Breakthroughs in the Cure of Desease
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Written by Frank J. King Jr., N.D., D.C.   
Friday, 30 May 2003 00:00

Dr. Samuel Hahnemann, the Father of Homeopathy, used the term “miasm” to describe the transgenerational causes to disease.  The word miasm means an obstacle  to cure, and Hahnemann asserted that unless this “obstacle to cure” is dealt with, the cure of disease will always be incomplete.  In modern terminology, miasm means diathesis or constitutional susceptibility or predisposition to a particular disease.  The deeper roots to disease can be traced back generationally to five primary diseases Hahnemann referred to as miasms.  The good news is that these predispositions to disease can all be corrected and cleared using homeopathy.
The five miasms are cancer, gonorrhea (sycotic), syphilis, tubercular (TB), and psora.  Miasms alter the ideal genetic blueprint for our health and can affect our entire being, physically, mentally, and emotionally.
Miasms can be either acquired or inherited.  One can acquire a miasm, for example, by contracting gonorrhea, say, at age eighteen.  When treated with antibiotics, this form of suppressive therapy can cause gonorrhea to go dormant and become active or show up later in life in the form of allergies, sinus, herpes, virginities, warts, tumors, suspiciousness, jealousy, selfishness or uncontrolled sexual desires.  Hence, acquired miasms are attained during our lifetime.
The far majority of miasms, however, are inherited.  The chance of inheriting miasms from thousands of years deep into our family tree is much greater than what we might acquire in our own lifetime.  Inherited miasms can be active or dormant.  A miasm that is active actually causes a present symptomatic picture or expression.  And, the best time to consider using a miasm formula is when the symptoms are present.  A dormant miasm is one hidden deep within the body, not expressing any of its possible symptoms.  It is recommended not to attempt treating dormant miasms unless other testing procedures, such as electro-diagnostic or reflex response tests, indicate the need for a specific miasm formula.
Homeopaths have experienced how miasms exist in various layers within the body, and understand that, as we work at correcting disease and building health, it is like pealing away the layers of an onion.  Regular homeopathic formulas work to strengthen and restore health to the body according to the symptomatic expressions the body is communicating.  When these conditions have a tendency to recur or be non-responsive, a deeper acting remedy, like a miasm, may be needed to more completely correct the condition.  As we continue to peal away the disease layers impairing our normal healthy expressions, we frequently discover various miasms along the way.
Miasm correction is essential to both the restoration of our health and the eradication of disease from our planet.  I have now used homeopathy long enough to see genetic disease patterns in people corrected and observe the liberation of those diseases later on in their own offspring conceived after miasm correction.  I have seen this remarkable healing phenomenon in cases such as childhood obesity, allergies, breathing disorders, skin disorders, and certain behavioral disorders, phobias and in anxiety-or nervous-prone people.  What a wonderful reward, not only to see both children and adults healed of devastating genetic or life-long health problems, but also to see their children born and grow up free of those inherited health problems and weaknesses in their families!

How do you treat miasms?

Miasms are matrixed—or integrated—into our inner most being from thousands of years deep into our family tree.  Although they are not difficult to correct with homeopathy, they are not always wiped out in a single blow.
Homeopaths have shown how disease patterns are trapped in and throughout the layers of our lives.  These layers are like clear overlays, as seen in global maps demonstrating how global shifts and changes in boundaries of countries have taken place over time and warfare.
Treating miasms can cause extreme changes in one’s health.  Commonly these changes can cause a wonderful enlightening euphoric experience, as well as times when a more intense cleansing crisis may occur, creating a temporary discomfort from the eliminative process.  Some of the commonly experienced cleansing symptoms may include emotional releases, skin breakouts, itching, fever, fatigue, bowel movement changes, breathing changes, and various forms of pain.  These symptoms, although temporary and non-damaging to the body, can be severe at times.  Remember, the body is orchestrating the healing crisis and will not harm or cause any permanent damage to it, even though it may feel like it at times.  Although the healing crisis is not always comfortable or convenient, it is essential to our optimal healing and restoration!
It is best to monitor patients closely when using the miasm formulas.  It is helpful to explain that there is a 60% chance of experiencing some form of cleansing response when taking a miasm formula.  This way, when they do experience these symptoms, they will understand the good purposes of eradicating the miasms.  Eradicating miasms not only helps us to better correct our present disease(s); it can also help prevent diseases in the future, both in our future offspring and ourselves.  Explaining ahead of time makes a big difference in the attitude of your patients when they go through a cleansing crisis.  When your patients are going through these uncomfortable times, it is much better to be praised for your wisdom than to be cussed in distrust.
Starting out a new patient who has not had experience with natural healing or detoxification with miasm treatment is not recommended.  They may not be strong enough to handle the elimination of the miasms in the most graceful of ways, especially if the patient is in a weakened state of health.  I recommend addressing the primary symptoms with symptom specific formulas first, along with detox and drainage formulas.  These products will help strengthen and restore the natural healing and eliminative functions, so that they can better deal with the deeper issues of the miasms later.

Miasms are great to use when patients:

  • Don’t respond to homeopathic treatment;
  • Don’t respond to other natural treatment;
  • Reach plateaus where they seem to level off in their health enhancement;
  • Continue to have reoccurrences with the same problem.

Miasms have a tendency to show up periodically throughout the healing processes over years.  Even miasms that didn’t show up previously in testing may show up later on in the treatment program, as more of the layers of disease have been pealed away.  Either the same miasm treatment or different miasm treatments will commonly be needed periodically over our lives.  It’s likely that almost everyone has at least one miasm; many people have more than one; and basket cases can have many miasms. TAC


Frank J. King Jr., N.D., D.C., is a nationally recognized researcher, author and lecturer on homeopathy.  In addition, Dr. King is the founder and director of King Bio Pharmaceuticals, a registered homeopathic manufacturing company dedicated to completing chiropractic destiny with the marriage of homeopathy.  Dr. King offers, complimentary to all Doctors of Chiropractic, his turnkey procedural system for the high volume practice called, The Chiropractic Enhancer systemÔ (CES).  It is so easy to use that you can successfully apply homeopathy in your practice using any company’s products in one day. Call King Bio Pharma-ceuticals, Asheville, N.C. 1-800-543-3245 or e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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Written by Jay Kennedy, D.C.   
Friday, 30 May 2003 00:00

Mechanical traction has been judged as a reasonable and logical treatment method for spinal pain for centuries.  Since compressed discs are often a source of chronic back and leg pain, stretching the spine is an intuitive remedy.1,2  However, it has never gained widespread popularity in the chiropractic profession, nor have its results been consistent in clinical trials.3  Cumbersome equipment, time consuming and uncomfortable procedures and its historical connection to physical therapy have kept it out-of-favor with perhaps the one profession best suited to its unique capabilities.

Within the last decade, however, traction has been making a reemergence in our profession.  It has taken on a new name and a new efficient profile.  It is now called decompression.4

Decompression or decompressive traction refers to a decrease in intradiscal pressure (and the resultant circulatory improvement and phasic healing concomitant with it).5  Specific protocols and systematic procedures reduce misapplication and the haphazard nature of previous methods.  In effect, decompression is best thought of as a hybrid traction method.

Several decompression units have entered the chiropractic market in the last ten years, most with a plethora of bells and whistles and extremely high price tags.  In the era of managed health care, lower equipment costs and lower overhead are the key to profitability, yet many DC’s have opted to purchase these units on the promise of dramatic outcomes and huge reimbursements.
Excellent results and patient satisfaction have always been the fuel that has powered the successful practice.  The promise of extraordinary results and reimbursements of $150 per treatment can be very persuasive in our competitive marketplace. 

Many chiropractors looking for a niche have discovered that, very often, patients unresponsive to manipulation or flexion do respond to the proper application of axial decompressive traction (that these units work is not really at issue).  They have discovered, additionally, that offering “…non-surgical decompression for disc problems” is an excellent means to attract new patients.6  This is due to its safety and comfort vs. traditional methods, not to mention the reduced strain on the busy doctor’s body!

However, the extremely high costs have often created undo financial stress on many practices.  The per-treatment reimbursement must be very high to validate the cost of equipment that leases for $1500+ a month for sixty months, or a charge of $50 each time you turn it on!

Many insurance companies are now enacting post-payment audits of DC’s billing decompression.  Any billing code other than traction (97012) can result in repayment, fines and penalties.  There is actually no decompression code, and rarely is an insurance company willing to pay $150 per treatment simply because the doctor paid  $50-125,000 for the equipment.7  I’ve owned several of these expensive decompression units over the last eight years and have been subjected to two audits u u resulting in six-figure reimbursements.  Of course, having the ability to up-sell a cash patient (or doing several additional modalities to generate $150 per session) begs the question, why not simply utilize an equally effective device costing one-tenth the price and watch your profits rise exponentially?

Recently, such equipment has become available.  One system which I particularly favor includes not only the unit, but also supportive diagnostic, and low-tech therapeutic devices.  Moving from passive to active procedures is a vital step in outcome-based care.  The included low-tech rehab device allows monitored exercise in the vital segmental stabilizers (the so-called local muscle system).8  Additionally, there are two methods of cervical traction and carpal distraction quickly and efficiently accommodated, all at a price around $10,000.  It becomes apparent to the experienced user that it’s the necessary utilitarian features, not the price, that allows for effective treatment.

An honest and objective analysis of the phenomenon of decompression brings us to the realization that it is an outcome that can be consistently produced by the adherence to several utilitarian characteristics and protocols.  It is probably not an overstatement to say, they are absolutely necessary for the most consistent, effective therapy. We contrast decompressive traction (i.e., decompression) from traditional mobilization traction methods by these characteristics.9   See Table 1.
These characteristics work in synergy to enhance the efficacy of Y-axis traction.  The synergistic effect of these characteristics is patient comfort and relaxation.  They reduce conscious and sub-conscious anticipatory guarding.  It has been suggested that muscle guarding reduces the ability of traction to distract the vertebrae sufficiently to decrease the internal pressure of the disk for a pre-determined time so healing can occur.  Thus, a slow, graduated application of tension and exact, reproducible forces make up a substantial aspect of decompression.12  It should be obvious that roller type tables and automated axial elongation on a flexion table have no ability to deliver real decompression.  Continued use of a traction code for that type of treatment can also lead to post-payment insurance troubles.

I can tell you from personal experience, it is unnecessary to spend extraordinary amounts of money in order to offer this beneficial therapy in your clinic.  Decompression therapy is now available for the cost of a quality adjusting table.  Look around!


Dr. Jay Kennedy has been practicing Chiropractic Biophysics (CBP) in Western Pennsylvania since graduating Palmer College in 1987.  In the last eight years, he has owned and operated several decompression systems treating over 2000 patients on them in his multi-disciplinary clinics.  He lectures extensively and has authored various articles on axial decompression.

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Written by TAC Staff: National Association News   
Thursday, 30 January 2003 00:00

American Chiropractic Association
Wal-Mart, ACA Meet to Discuss
Value of Chiropractic

The ACA and Wal-Mart forged a new working relationship after meeting in December 2002, to discuss the company’s decision to drop chiropractic services from its employee benefits in 2003.  Wal-Mart indicated a willingness to look at new data regarding the cost-effectiveness of chiropractic care.
The ACA was represented at the meeting by ACA President Dr. Daryl Wills, ACA Chairman Dr. James Edwards, ACA Executive Committee Member Dr. George McClelland and ACA Vice President Patricia Jackson.  Wal-Mart representatives included the Senior Vice President for Benefits and Claims, and the Vice President for Benefits.  Dr. Ted Morter, III, a local DC whom Wal-Mart officials know and respect also attended.  
ACA presented Wal-Mart with research showing how chiropractic can reduce costs by deterring the need for drugs.  “We want Wal-Mart employees to have a choice in health care, and allowing employees to choose chiropractic will benefit not only their health, but also their productivity,” explained Dr. Wills.
The benefit that Wal-Mart is cutting in 2003 impacts approximately 85% of associates enrolled in the PPO plan.  The remaining 15% of associates with HMO coverage, and those with Workers Compensation claims, have chiropractic benefits intact.  Although only 15% of Wal-Mart employees choose to enroll in an HMO, over a third of Wal-Mart employees have access to an HMO.
“Losing chiropractic as a core benefit will be a deterrent for employee utilization,” said Dr. Edwards.  “ACA will work with Wal-Mart to ensure paid health care options for employees who choose non-surgical and drug-free care.”

International Chiropractors Association
New Coalition Organized to Defend Chiropractic Independence

According to a newly formed coalition, chiropractic is in danger of being taken over by a group of medically oriented chiropractors and organizations who are trying to change the very nature of the profession, and in the process minimizing the profession’s unique role in health care and possibly placing the public at risk.
The Chiropractic Coalition—founded in November 2002 by three major chiropractic organizations, the International Chiropractors Association (ICA), the World Chiropractic Alliance (WCA), the Federation of Straight Chiropractors and Organizations (FSCO)—cautions that several rogue groups are trying to position chiropractors as quasi-medical doctors, unnecessarily and irresponsibly blurring the boundary lines between the professions and confusing the public.
The Coalition specifically referred to the Council on Chiropractic Education (CCE) and the Federation of Chiropractic Licensing Boards (FCLB) as two of the groups, which were overstepping their authority in an attempt to control the direction of the profession.
“These groups, which are by no means representative of the tens of thousands of doctors of chiropractic active in the United States, are trying to change educational requirements and state licensing statutes to allow, and even require, chiropractors to diagnose and treat diseases and medical conditions, at the expense of the focus on chiropractic’s unique procedures,” noted ICA President Dr. D.D. Humber. “Public interest in and demand for subluxation care is growing, and their needs and concerns must be chiropractic’s first priority.”
The real danger, warns the Coalition, is that chiropractors will be forced to provide services that aren’t within the scope of chiropractic. Expecting chiropractors to act as medical doctors will not only destroy the unique character of chiropractic, but most importantly will put the public at risk, the Coalition says.

World Chiropractic Alliance

Kristina M. Collins, D.C., a member of the WCA International Board of Governors, is one of six new members appointed by the National Center for Complementary and Alternative Medicine (NCCAM) to its National Advisory Council on Complementary and Alternative Medicine.  The Council is the principal advisory group to NCCAM, a component of the National Institutes of Health.  Dr. Collins is a subluxation-based doctor who enjoys educating the public about the role of chiropractic in health and wellness, and about the benefits of chiropractic for children.
The WCA has issued a position paper on the duty of chiropractors to diagnose, inform patients of unusual findings, and make referrals to other health care practitioners.  The lack of a standard definition of chiropractic diagnosis has resulted in numerous malpractice lawsuits and confusion among the public.  “The health care landscape is dotted with malpractice land mines. The World Chiropractic Alliance’s position paper is intended to provide guidance in these matters, and support in court and before boards,” the WCA announced.  The paper is posted on the WCA website,
A new WCA Chiropractic Advocacy Council, headed by Matthew McCoy, D.C., has been formed to help doctors locate resources to defend themselves in court or before a board, respond to media attacks, and combat discrimination by regulator agencies, HMO’s, insurance companies, state chiropractic organizations, and other groups.  The Council provides information, resources, and support on issues such as diagnosis, stroke, caring for asymptomatic patients, record keeping and chiropractic for children. For more information, visit
www.worldchiropracticalliance.org/councils/advocacy.htm. TAC

Consciousness is the Key
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Written by Patrick Gentempo, D.C.   
Thursday, 30 January 2003 00:00

I was recently interviewing a “chiropractor of the month” for our On Purpose tape series.  She is also a Total Solution graduate and runs a very successful practice in Georgia.  We got on the topic of what it had taken to build her practice, and she communicated to me that she had gone from zero to 250 patient visits per week in her first week.  After I picked my jaw back up, my reflex interrogation was, “What did you do?  How did you make that happen?”  I knew that these were the wrong questions as they were leaving my mouth.  My experience, after consulting with thousands of chiropractors, tells me that success is a consciousness and not a procedure.  Give me a room with one hundred chiropractors in it.  Let me teach them all the same procedure.  Have them all execute it the same way.  They will get one hundred different results. 

Don’t get me wrong, extraordinary procedures are vital to a successful practice.  Without them, a practice has no staying power and the practitioner burns out.  But, extraordinary procedures void of a consciousness of success and purpose will not build a dream practice.  Incidentally, when I asked the chiropractor above who saw 250 visits her first week how she had done it, she replied, “ I worked as an associate for years in a practice that saw over 1,000 patient visits per week.  When I started my own practice, I didn’t expect it to be any other way”.  It wasn’t her procedures as much as it was her consciousness, which created her expectations, which created her reality.  It is procedures that will continue to bring her consistent, rewarding, low stress results.  It is consciousness that creates the practice in which the procedures can be used.

Chiropractic is a consciousness before it is anything else.  It entails a critical philosophy that creates a mindset that directs thinking and actions and provides purpose—purpose being defined as the object for which something exists.  This consciousness, which provides purpose, is the very foundation on which a human life is built.  Mediocrity and failure come from an undefined, contradictory philosophy, which leads to a muddy consciousness (mudhead), which leads to a lack of purpose, which leads to a constant state of survival, no matter how good your procedures are.  Success, wealth, and reward come from a well defined, non-contradictory philosophy, which leads to clear consciousness, which leads to a powerful sense of purpose, which leads to a constant state of success and perpetual, never ending improvement. 

For the past several years, success consciousness has been a serious cultural trend.  Companies like Nightengale-Conant, Successories, and so on, are testaments to this.  Unfortunately, many self help gurus have their followers try to create a success consciousness through hype and psychological means.  This leads to short term benefit and, indeed, the person applying such techniques may end up in a less desirable self-circumstance due to the roller coaster effect.  When you try to improve yourself based on psychological hype, you typically end up with an “adrenalin high” which is short lived and drops you hard.  This creates a phenomenon I refer to as the “self help junkie”.  It is kind of like people who spend their whole lives going from diet to diet, always losing weight when they start the new diet, gaining it back, and then going to the new diet, hoping for a better result, and ending up having the same experience.  In chiropractic terms, these types become seminar junkies.  The signs and symptoms demonstrate that the afflicted go to seminar after seminar, get pumped after each, the practice goes up for a short while, and then drops, until the next program.  Don’t get me wrong.  I love seminars and lecture at over fifty a year.  An appropriate experience, though, would be a continual qualitative and quantitative change in your practice and personal experience as a result of attending these programs.  If you are not improving or, worse yet, if you’re burning out, you are working from the wrong model and wrong consciousness. 

If you are trying to deal with issues on a psychological, rather than philosophical, level, you are dealing with effect, rather than cause.  This creates the “junkie’s” dependency.  Psychological emotions are secondary to interpreted perceptions, which are the primaries.  In other words, it is your perceptions, filtered through your philosophical constructs, which result in your emotional responses.  Many people share a common experience, yet may end up with very different emotional responses.  A certain event may occur, and one person may be thrilled, another horrified, and a third indifferent.  The event is the same.  The perception of it, based on individual philosophies, may be different, thus, leading to different psychological experiences.  Therefore, if we start developing ourselves on the psychological level, without first addressing the philosophical level, we may end up in a rat’s maze.  I’ve consulted with a lot of chiropractors who find themselves there.  Each new technique that gets them to “change their emotional state” just sends them down another blind alley.

In summary, in order to develop a success consciousness, one must start by clearly identifying ones philosophical premises without contradiction, develop a long-range conceptual purpose (which only humans can do), and then experience the psychological and spiritual results.  The cleaner your philosophy, the greater your experience and rewards.  There is a great trend toward self-improvement and expanded consciousness.  Without philosophy, it’s all smoke!

A 1983 graduate of Life College, Patrick Gentempo, Jr., D.C., is co-founder and CEO of the Chiropractic Leadership Alliance, in Maywood, NJ, and co-creator of the Total Solution program.  An internationally renowned chiropractor, lecturer, and consultant, he has helped thousands of chiropractors achieve success and balance in their lives.  For information about CLA seminars, products, and services, call 800-285-2001, or visit www.subluxation.com.


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